Special Report: Are e-cigarettes a safe alternative to smoking?

Electronic cigarettes are being touted as a safer way to get a nicotine fix, or a way for smokers to break a nasty habit, and the number of stores selling e-cigarettes and liquid nicotine in Montreal is growing.

But selling e-cigarettes is illegal under federal law.

Growing marketplace

Two years ago Vaporus was the only shop in Montreal selling e-cigarettes, and now there are about two dozen stores offering the cigarette substitutes.

Julien-Pierre Maltais is the manager of the store, and he and his employees offer every first-time customer a tutorial about how the products work before being sold a starter kit.

"There are three components to an e-cigarette," said Maltais. "There's the battery, there's the atomizer which heats up the liquid and is usually contained in a tank of some sort which is a receptacle for the last part which is the e-liquid."

The flavoured liquid, or e-juice, contains small doses of nicotine, along with propylene glycol and vegetable glycerin to produce vapour - the source of the term 'vaping' - and gives users the "throat hit" they crave.

"When you smoke a real cigarette you feel a little burning, tingling sensation. Well the same thing applies to an e-cigarette depending on the nicotine level that's in the juice," explained Maltais.

Smokers switching, new users experimenting

Marc-Olivier D'Astous is one former smoker who made the switch to e-cigarettes.

"Last autumn these shops started popping up everywhere, so I got off those nicotine gums with this," he said.

Users can gradually reduce the level of nicotine in their e-juice or eliminate it altogether, and those contemplating e-cigarettes for the flavour factor alone never have to introduce themselves to nicotine addiction.

18-year-old Matthew di Perma just started vaping without any nicotine because he likes the taste of Hawaiian Punch.

"I find it tastes good and it's just a hobby," said Di Perma, who has several friends who use e-cigarettes.

Doctors divided about safety

Some doctors are recommending their patients use e-cigarettes as a way to cut back on deadly tobacco smoking.

Dr. Sean Gilman of the Montreal Chest Institute says many patients who want to quit smoking are asking about e-cigarettes.

"There are physicians that are very excited to have a new technology to help our smokers reduce their harm and I'm included in that group of people who are excited that there is a new technology," Dr. Gilman said.

But the technology is so new it's not clear what the long-term effects are.

"You don't have the tar, the combustibles, the 4,000 chemicals that come out of the combustible cigarette so it's likely to be much safer than a cigarette, but we just don't know for sure yet," said Dr. Gilman.

He does want to see federal authorities do more to investigate them.

"I think that Health Canada has to regulate the usage of e-cigarettes. As long as we have regulations and it was viewed as either a tobacco product or as a medication, and rigorously studied and allowed to be sold after it is reviewed in an evidence-based manner, then we have a very good product on our hands," said Dr. Gilman.

Long-term effects unknown

Health Canada says there is not enough evidence to show the benefits of e-cigarettes outweigh the risks, and until the evidence is in it does not want Canadians using e-cigarettes.

The federal agency is very clear on one aspect: nicotine-containing products are strictly regulated, and so far there are no laws permitting the sale of e-cigarettes.

In a written statement Health Canada told CTV "no such products have been approved to date (...) the advertisement and sale of electronic cigarette products, including e-liquid, that contain nicotine and/or have health claims is non-compliant with the food and drugs act., and is therefore illegal."

Yet vape shops keep popping up because the laws about trading in nicotine are not being enforced.

Demand for regulations

That has Montreal's Public Health Department calling for clear regulations and quality control measures, something vape shop owner Maltais supports.

"We want to make sure that people that vape... get good stuff, they get good liquid that's not made on the corner of a table in a little apartment," said Maltais.

He is also careful not to market e-cigarettes as medication.

"We don't claim they do anything. We will never sell this to someone and tell them,'This is to help you quit smoking.' This is simply an alternative to regular cigarettes," said Maltais.

Anti-smoking advocates like Mario Bujold are worried that many vapers are using them as an alternative to tobacco, and worry that regulations are not being enforced.

"There's really a risk for public health to renormalize the act of smoking in different public places, like restaurants, bars, hospitals, schools, airplanes," said the president of the Quebec Council on Tobacco and Health.

He also worries that teenagers like Di Perma are being seduced by flavourful e-juice, saying the number of teen users in the U.S. is growing.

"During a one-year period, it more than doubled, the proportion of teenagers who are using e-cigarettes, so there's really a trend there and we have to really be careful about that," said Bujold.

But until health authorities enforce current regulations, or create new ones, former smokers like D'Astous will continue to spark up, confident that e-cigarettes are, if nothing else, better than a standard cigarette.

"I'm sufficiently confident that it's okay. If you look at the ingredients, the way it's made, the way it works, for me it's a safe bet."